Chronic Pain Support Group
Physicians and professionalsdefine pain as chronic if it lasts longer than three to six months and is persistent. It's distinct from acute pain that is a direct result of injury or trauma. This support group is dedicated to those suffering from chronic pain. Discuss treatments that have worked for you, find advice for your specific experience, and find support. You're not...
I'm curious. When I 1st began with my new doctor (my doc of many years died over a year ago) he said that he couldn't keep me on the same doses my previous docs had, b/c of some rule or law that had been passed. He said he was very sorry b/c the doses had worked for me for 14 years w/o ever needing an increase, but he had to follow the rules and he'd feel terrible if he had to stop helping people fight pain just b/c he broke the rule.
The rule is, a patient cannot take more breakthrough or short-acting medications a day than long-acting meds. For instance: I USED to take MSContin 60 mg 3 x a day with two 30mg MSIR pills every 4-6 hours as needed, averaging 6 a day, maybe 8 in the winter. (8 would be RARE- it would be the worst possible flares.)
3 docs before this doc had discovered that I responded better to quick acting or, instant released meds. But because the INSTANT release only came in 15 and 30mg, to prescribe what I'd taken before would be breaking the rule.
Now, I never thought of them as breakthrough meds really- I just thought of them as a regime- just a way to take the same medication in different doses so it covered the pain and I was able to work and be a mom and wife, etc.
He changed the long-acting to a stronger dose but cut the quick acting to 3 a day. I was okay for awhile, but now I'm having trouble. I have an option to go to a stronger medication but I do NOT want to do that. This med works for me and if only I had a little leeway, I'd be back to where I was a year ago. I also don't want to start a new med b/c I have a young son and a job. I can't take the time to start all over.
I'm okay on what I'm on, but it'd be so much better if I was on the old schedule. I would never ask him to break a law- not in a million years! He's a great guy who follows the rules to a T and I respect that! I just wonder where this rule came from.
Has anyone heard of this? Is it a Federal law or a guideline or what? How did my docs before this prescribe it the old way for all those years? It just basically says that if I take 3 long-acting, I can only take 3 quick-acting. They don't take into account that the quick-acting doesn't come in a stronger dose.
Anyway, it's bugged me for a YEAR and now I want to know if anyone has heard of it, and if so, is it a LAW? Is it the Fed Govt or a state thing? I just want to know what I'm dealing with before my next appointment. If it's a LAW I won't even bring it up. But if it was one of the weird rules that the govt was putting into effect and then pulling back, etc., I would ask for the switch. At least a small switch.
After 15 years, my RSD has decided to take over, and I'm not liking it much. I have just a small area to work with, and only when the RSD is unbearable.
Anyone? And thank-you. :)
The rule is, a patient cannot take more breakthrough or short-acting medications a day than long-acting meds. For instance: I USED to take MSContin 60 mg 3 x a day with two 30mg MSIR pills every 4-6 hours as needed, averaging 6 a day, maybe 8 in the winter. (8 would be RARE- it would be the worst possible flares.)
3 docs before this doc had discovered that I responded better to quick acting or, instant released meds. But because the INSTANT release only came in 15 and 30mg, to prescribe what I'd taken before would be breaking the rule.
Now, I never thought of them as breakthrough meds really- I just thought of them as a regime- just a way to take the same medication in different doses so it covered the pain and I was able to work and be a mom and wife, etc.
He changed the long-acting to a stronger dose but cut the quick acting to 3 a day. I was okay for awhile, but now I'm having trouble. I have an option to go to a stronger medication but I do NOT want to do that. This med works for me and if only I had a little leeway, I'd be back to where I was a year ago. I also don't want to start a new med b/c I have a young son and a job. I can't take the time to start all over.
I'm okay on what I'm on, but it'd be so much better if I was on the old schedule. I would never ask him to break a law- not in a million years! He's a great guy who follows the rules to a T and I respect that! I just wonder where this rule came from.
Has anyone heard of this? Is it a Federal law or a guideline or what? How did my docs before this prescribe it the old way for all those years? It just basically says that if I take 3 long-acting, I can only take 3 quick-acting. They don't take into account that the quick-acting doesn't come in a stronger dose.
Anyway, it's bugged me for a YEAR and now I want to know if anyone has heard of it, and if so, is it a LAW? Is it the Fed Govt or a state thing? I just want to know what I'm dealing with before my next appointment. If it's a LAW I won't even bring it up. But if it was one of the weird rules that the govt was putting into effect and then pulling back, etc., I would ask for the switch. At least a small switch.
After 15 years, my RSD has decided to take over, and I'm not liking it much. I have just a small area to work with, and only when the RSD is unbearable.
Anyone? And thank-you. :)
Many states have jumped on the pain meds are bad wagon that started with the DEA long before Obama became president. This is separate from the affordable health care bill known as Obama care. States not completely understanding the difference between an addict and someone with CP is treating all as addicts and some are making laws that clearly restrict pain meds just because someone might abuse the meds. It's the Nanny state philosophy.
I understand in some states they are going after doctors who meet with pharma reps that make pain meds as if the reps are forcing doctors go write more pain med scripts because it works that way with viagra and boniva in their opinion. I guess doctors can no longer determine what meds to write for with a a pharma rep telling them to and giving them those cool pens as incentive.
I've had 3 docs in 15 years, 1 retired, 1 died, and my current doc. The previous 2 docs PLUS the docs they worked with, believed that I have a different metabolism. They saw it a lot, and my docs didn't deal with addicts. IN fact my 2nd doc (may he rest in peace) was a Psychiatrist before becoming a CP doc. He always said he could spot a liar a mile away and to this day I respect what he did for pain patients and also, how he got rid of addicts who tried to get in to see him.
You are lucky you can survive on a small dose, and yes, it's important to stay ahead of the pain. As long as you're not letting your fear of addiction keep you in pain, you're doing VERY well! Just remember there are a LOT of people who take large amounts of quick acting, and they're not addicts. In fact I always thought that addicts preferred long acting meds and they crushed them? I've seen it on tv and the movie Oxycontin Express.
I don't doubt there are addicts, just don't think many CP patients are spending money and time and living this life to get high. Some- sure, but most of people I know here would love to be able to live life w/o any meds at all. I'm at a hotel so I can catch an early flight in the am and believe me, I HATE having to worry about what meds to bring, how many, and what to do with the meds at home. It's a pain, pardon the pun, to have CP.
As for my meds, I already increased the long-acting, it's been over a year and it doesn't work well for me. I don't think I want to go back to exactly what I was taking, but 1 or 2 more MSIR a day wouldn't kill me. The MSContin doesn't last more than 6 hours after 15 years on it. (14 years on 60mg and 1 year on 100mg.) I also know I'm not the only one with an odd metabolism with meds.
I get where you're coming from, but I respectfully disagree. I can't take any more long-acting and it only lasts 6 hours, so it's not my kind of medication. As a background med, it's good. But the MSIR worked to relieve the worst part of RSD which is the burning. I miss being completely free of that.
I hope you continue to deal well with the pain and not need high doses. It's expensive, it takes up too much time in my life, and i hate taking time from my son. I envy you.
1litteb- What YOU said, LOL!!! I'm so sick of "Obamacare" this and Obamacare that- it's giving people medical care, right? Fiscally I SHOULD be a Republican, but I've always believed that those with more should pay more. Not that I believe we should be paying as much as we do, but I'd rather that we, who can afford to pay a bit more, do. NOT as much as we pay, but certainly more.
Besides- if DH and I agreed on everything, it'd make for a boring marriage, LOL!